Adaptações e improvisações: repercussões para o processo de trabalho hospitalar da enfermagem

• Autor(a) principal: Santos, Déborah Machado dos
• Data de Publicação: 2012
• Tipo de documento: Dissertação
• Idioma: por
• Título da fonte: Biblioteca Digital de Teses e Dissertações da UERJ
• Texto Completo: http://www.bdtd.uerj.br/handle/1/11383
• topic: Nursing in hospital environment; Nursing management; Work process; Work conditions; Adaptation; Enfermagem em ambiente hospitalar; Gerenciamento de enfermagem; Processo de trabalho; Condições de trabalho; Adaptações; CNPQ::CIENCIAS DA SAUDE::ENFERMAGEM

Investigation of the phenomenon of adaptation and improvisation practices in the use of materials and equipment in hospital environment is relatively recent in the heath sciences. It can be inferred that those artifacts result predominantly from neoliberal-natured policies, which generate qualitative and quantitative shortage of material and human resources, with effects on care management and assistance. Object: impact of improvisation and adaptation practices in the use of material resources in the nursing work process in hospital environment. Objectives: I) to describe adaptation and improvisation of material and equipment in hospital environment; II) to analyze the consequences of adaptation and improvisation in the nursing work process; III) to discuss adaptation and improvisation practice-related conceptions to the quality of nursing and to client s health in the view of nursing workers. Qualitative and descriptive research, developed in a general hospital in Rio de Janeiro, RJ, Brazil. Subjects comprised twenty nursing workers. Data collection was based on semi-structured interviews and systematic observation. Analysis methodology was content analysis. Three empirical categories emerged out of content analysis technique: category 1: context of adaptation/improvisation in hospital environment; category 2: adaptation and improvisation of material resources found in the organization as well as in the nursing work process; category 3: dialectics of adaptation and improvisation practice to the quality of nursing and client s health. Results have consolidated the understanding that adaptation and improvisation derive primarily from a context of growing precarization of working conditions, which urge workers to make up ways to ensure nursing care. Adaptation and improvisation were found to interfere in the work process, in the sense of increasing the workload, the nursing modus operandi, the time spent on the creative process, nursing professionals commuting, and difficulties abiding by scientific principles in emergencies. However, it was found that nursing relies on a wide spectrum of adaptation and improvisation in favor of assistance. However, dialectic conceptions can be identified, which symbolize both positive and negative aspects to nursing care as well as to client s health. Conclusions show that the work process at the hospital is not in accordance with the practical needs of nursing care delivery. It generates work overload, adaptation and improvisation, and ultimately, transgressions to the work prescribed.